Transcript Slide 1

Home Visiting Programs for
Young Children and Families
Lynda Cook Pletcher
NECTAC
Inclusion Institute May 19, 2010
• How many of you
do home visiting?
• Under which
programs?
Particular model or
Approach?
• Who do you serve?
What does the visit
provide families and
children?
Long History of Home visiting
1880’s “friendly visitors” to the poor or immigrant
families aimed at improving the lives of mothers and
young children
Same time period Hull House in Chicago model
spreads to other large cities improving the lives of the
poor (one- stop- shop for services)
1900’s organized nurse visits after births; maternal
child health home visiting nurses established later
decade
Mary Richmond's Advice to the visitor
in 1899:
 Relief should be given individually and privately in the home; the head
of the household should be conferred with on all questions of relief,
 We should seek the most natural and least official sources of relief,
bearing in mind the ties of kinship, friendship and neighborliness and
avoid a multiplication of sources,
 We should not only look to the alleviation of present suffering, but to
promoting the future welfare of the recipient,
 Instead of trying to give a very little to many, we should adequately help
those we help at all,
 We should help the poor to understand the right relations of things by
stating clearly our reasons for giving or withholding relief, and by
requiring their cooperation in all efforts for their improvement,
 We must find that form of relief that best fits the particular need.
Home visiting programs work in two
ways: both related:
The Program itself is a service and support
 Visitor uses family support principles to create a trusting and
“helpful” relationship (emotional support)
 Delivers a services such as parent education, home health,
screening (informational, material support)
Offers links to other community supports and
services for child and family
 Formal Services - to medical, educational, social services
 Informal support - to playgroups, libraries, parks, friends
For today’s session, the two major
categories of home visiting programs:
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IDEA Part C/Early Intervention- Services and supports
for eligible children with disabilities or “known conditions”
to improve outcome for children and families.

Programs designed for vulnerable populations of
children and families to improve child and family
outcomes education, parenting, heath, follow-up etc.
Birth to 3, Early Intervention(Part C of IDEA):
Common underlying themes
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Services in natural environments
Family centered practices
Relationship based approaches
Activity based leaning
Natural learning opportunities
Functional outcomes
Team based service delivery
Collaboration with other agencies and service
providers at state and community level
The girls at the park….
Mission for Part C Services
Part C early intervention builds upon and
provides supports and resources to
assist family members and caregivers
to enhance children’s learning and
development through everyday learning
opportunities. (OSEP TACommunities of
Practices services in Natural Environments
workgroup 2007)
Key Principles for Working with Families
Workgroup on Principles and Practices in Natural Environments (November, 2007) Mission and
principles for providing services in natural environments.
OSEP TA Community of Practice-Part C Settings.
http://www.nectac.org/topics/families/families.asp
 Infants and toddlers learn best through everyday
experiences and interactions with familiar people in
familiar contexts.
 All families, with the necessary
supports and resources, can
enhance their children’s
learning and development.
 The primary role of a service
provider in early intervention is
to work with and support family
members and caregivers in
children’s lives.
Principles Continued
 The early intervention process, from initial contacts
through transition, must be dynamic and individualized to
reflect the child’s and family members’ preferences,
learning styles and cultural beliefs.
 IFSP outcomes must be functional and based on
children’s and families’ needs and family-identified
priorities.
 The family’s priorities, needs and interests are addressed
most appropriately by a primary provider who represents
and receives team and community support.
 Interventions with young children and family members
must be based on explicit principles, validated practices,
best available research, and relevant laws and
regulations.
State named approaches:
States are using and blending a variety of
approaches throughout their states. A few
states have adopted one particular approach
and are in early implementation stages to go
“statewide”. Other states are considering
implications of adopting or adapting one
particular approach in pilots or small
geographical areas. (see chart)
Most common named Part C
approaches for delivering services
 Primary Service Provider with Coaching
(Rush,Shelden and Hanft); Geographical based team
where one member, primarily, is assigned to the family and
uses coaching techniques and natural learning environment
practices and receives coaching from other team members.
www.coachinginearlychildhood.org/index.php
 Family-Centered Intervention in Natural
Environments (McWilliam); uses a primary service
provider with backing and assistance from team, eco-mapping,
routine based interview (RBI) and intervention, support based
home visit, collaborative child care consultation
www.siskin.org
Approaches Continued
 Family Guided Routines Based Interventions (FGRBI) draws
off two earlier models called FACETS and TaCTICS (Woods);
built on collaborative teaming, natural routines and family
centered practices, routine based assessment, linking
assessment to intervention, involving care givers in teaching
and learning and monitoring progress.
http/fgrbi.fsu.edu/
 Everyday Routines and Activities (Dunst and Bruder)
family life is rich in locations, activity settings leading to many
naturally occurring learning opportunities for enjoyable mastery
of new skills.
www.everydaylearning.info/index.php
Sidewalk chart and water-colors, language, science
experimentation and FUN!
The Case for Home Visiting
“Voluntary home-based programs, also know as home
visits, match parents with a trained professional to
provide information and support during pregnancy
and throughout the early years.
By helping parents learn how to care for their children
and themselves, families reap the benefits. Children
are safer, healthier and, better prepared to learn and
more likely to become successful adults.”
(May 2010, Pew Center on the States: The Case for Home Visiting)
Typical goals of these home visiting
programs
 Increasing positive parenting practices and improving
parent child relationships
 Reducing child abuse and neglect
 Improving child health and development
 Increasing school readiness and academic success
 Improving children's emergent language and literacy
skills
 Enhancing parents’ self-sufficiency
(December 2009, Extending Home Visiting to Kinship Caregivers… CLASP)
Most common home visiting
approaches/programs
Early Head Start (EHS)
www.acf.hhs.gov/programs/ohs/
 Healthy Families America (HFA)
www.healthyfamiliesamerica.org
 Parents as Teachers (PAT)
www.parentsasteachers.org
 Nurse-Family Partnerships (NFP)
www.nursefamilypartnership.org
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National home visiting programs continued:
Home Instruction of Parents and Preschooler Youngsters
(HIPPY) www.hippy.org.il
 The Parent child Home Program (PCHP)
www.parent-child.org
 Healthy Start
http://www.healthystartassoc.org/
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Many, many other commercial materials and curriculum
available
State status of Home Visiting
Programs
 All states and territories participate in IDEA PART C
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but have differing eligibility criteria.
At least 40 states have one or more state-based
home visiting programs using a national model or
state designed approach for some portion of eligible
populations.
All use a variety of funding sources: federal, state
and local dollars.
Some states work hard at state and local
collaboration among the HV opportunities.
“Wait he’s coming in the house??? Take him back to the
hospital”
Renewed Emphasis from
Congress
Home Visitation Program in the Patient Protection and
Affordable Care Act (2010)
http://www.clasp.org/admin/site/publications/files/home-visiting-detailedsummary.pdf
 Includes $1.5 billion of mandatory funding over five years to
significantly expand home visitation services, helping to ensure
that more children have the opportunity to grow up healthy,
safe, ready to learn, and to become productive adults.
 The program will provide grants to states, tribes and other
eligible entities to deliver a range of services to eligible families.
The goal is to promote better prenatal and maternal health,
infant health, and child health and development.
Home Visitation Program in the Patient Protection
and Affordable Care Act (2010), continued
 In addition, the program works to enhance parenting
skills to improve child development and school
readiness, and it provides services to improve families'
socioeconomic status and reduce child abuse and
neglect.
 Grantees can select an array of models that, based on
research, have demonstrated positive outcomes for
participants.
 Any state entity - not just health, may apply.
 Needs assessment must be done and include high risk
populations including low-income, at risk communities,
domestic violence, premature birth, disabilities etc.
Other Resources:
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The Pew Center on the States - Home Visiting Initiative
http://www.pewcenteronthestates.org/initiatives_detail.aspx?initiativeID
=52756
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CLASP - Center for Law and Social: Strengthening Children and
Families - Child Care and Early Education
http://www.clasp.org/advocacy_areas?type=strengthening
children_youth_and_families
National Center for Children in Poverty - State Based Home Visiting:
A report
http://www.nccp.org/publications/pdf/text_862.pdf
NECTAC topical web pages “Home Visiting”
www.nectac/org/topics/homevisit/homevisiting.asp
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What does this mean to all of us?
Need for more
coordination and
collaboration at the state
level to push this “thing” up
hill.
Work together at the local
level to keep program
planning and services
coordinated
Serve more families so
better outcomes for young
children.